Discussions of Mental Health Issues for Gender Variant and Transgender Individuals, Friends and Family with posts by NYC Psychotherapist Ami B. Kaplan, LCSW.

Posts from the ‘regret’ Category

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”. This post attempts to explore this phenomenon.

Some reasons why this might occur include:

The person is not transsexual. The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender. Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t. Sometimes the discovery just isn’t possible without trying it out. The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.

Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness. I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as: the idea that one will have a social community, better social skills, be more popular, etc. When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition. It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through. Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.

The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life). These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender. Additionally, transitioning is hard. There are many hoops to jump through and one enters into a group of discriminated against people. This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition. The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”. Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery. These included 2000 individuals from 1961 to 1991. This doesn’t take into account individuals who transition without surgery. About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Like this:

The LA Times posted a long follow up article on the suicide of Mike Penner/Christine Daniels, the late LA Times sportswriter who transitioned on the job (and which I wrote about in a previous post)

A few things stand out as contributing to the suicide:

A very painful separation and divorce from her wife. Complicating matters was the fact that they worked in the same office and wife expressed her wish to avoid all contact with Christine. (I’m certainly not blaming the wife for contributing to the suicide; I’m just saying that the separation and circumstances were painful for Christine.) There was also the loss of the wife’s family, who Penner was close to.

Being a public figure, she got some harsh (and ignorant) public criticism of her ability to “pass”, which was hard on Christine.

Christine being thrust into and accepting the role of spokesperson for transgender issues when she probably wasn’t ready or personally strong enough to deal with the media scrutiny. Then having disagreements with trans activists who objected to Daniel’s emphasis on appearance in her blog.

Daniels withdrew from friends, church and public appearances.

Daniels’s mother died.

Daniel’s focused on her transitioning as the root of all her problems and tried to de-transition in hopes of reuniting with his wife.

What are the lessons that can be gleaned from this?

There is a great need for support during and after transition. Don’t underestimate the need for supportive people and institutions. Including friends, family, support groups, therapy, religious institutions, knitting circles, etc… Its like drinking water in the desert – you have to do it even if you’re not feeling thirsty – if you feel thirsty its too late – you’re already dehydrated.

Withdrawing is not the answer. It will only make things worse.

Very often when people find themselves a part of a new group they feel they have to be a spokesperson/activist/possess complete knowledge of said group. That’s great if you want to do that, but it should be a conscious choice and not an obligation.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.